Psych Central

Anxious about Sex

By Dr. Marie Hartwell-Walker

Hello I am a 27 year old heterosexual man and I tend to avoid sexual encounters because I am unable to relax. I have had a major depressive disorder with the attendant anxiety component in the past and whilst I know it’s not so simple as being “cured”, I am certainly in a better position in that regard than I was, say, 3 years ago.

I have rejected many romantic advances, and it has become de rigeur for me to terminate a relationship just as it is about to turn sexual, because I become so nervous that I either prematurely ejaculate or I fail to get an erection. One two occasions I even deliberately lied about my reasons for ending the relationship. I’m not at all proud of that but I was cruel enough to two women to drive them away, because it was easier than having to talk to them.

I don’t struggle with sexual function itself – I am able to masturbate and maintain an erection on my own without difficulty – but when faced with the sexual act everything changes. I don’t believe I have a sexual aversion disorder or anything – I’d like nothing more than to be able to have sex, but the anxiety kicks in straight away.

The biggest problem is that the anxiety is very unfocused – I can’t articulate it. It’s not quite “What if I don’t perform to standard?” and it’s not quite “what if she doesn’t have an orgasm?” – I know, rationally, that these are not productive things to ruminate on. I feel like, for all the progress made elsewhere in my life regarding depression/anxiety, I haven’t made any in this regard. I have tried asking for patience but unfortunately patience is not infinite. In the end, I beat myself up for not going through with sex, and that feeds into my anxiety when the next opportunity for sex comes up. It’s a vicious cycle – I don’t expect that you’ll be able to come up with any long-term therapeutic strategies for me, but can you at least help me stop punishing myself? Am I just picking the wrong partners? How many more people to I have to let down?

A: I don’t know if you’re picking the wrong partners. I do know that you’re right: Your anxiety about sex is the problem. The fact that you can ejaculate while masturbating shows that your plumbing works. But successful masturbation doesn’t necessarily translate to loving sex with a partner. You can orgasm quickly and efficiently when you are doing self-service. Yes, you get the release. But you don’t get the intimacy.

My guess is that you are too focused on orgasm and not focused enough on your partner. Change your goal to giving and receiving closeness and pleasure. Long lazy times in bed, hugging, kissing, cuddling and giving your partner what makes her feel good is its own kind of sweetness. Put your worries about your own orgasm aside. Let your partner know it doesn’t matter if you come or don’t. What matters is that you’re together and sharing an intimate time. If you can make love generously and selflessly, you will eventually relax enough for your body to respond.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 11 Nov 2013

APA Reference
Hartwell-Walker, D. (2013). Anxious about Sex. Psych Central. Retrieved on April 20, 2014, from http://psychcentral.com/ask-the-therapist/2013/11/11/anxious-about-sex/